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International Society of Surgery

Society Zone takes a closer look at Springer’s relationship with the ISS, and talks to Dr. Felix Harder, former Secretary General of the ISS.

After Medical School in Basel, Switzerland, Felix Harder devoted the years from 1963-67 exclusively to experimental surgery. His two most fascinating years during this time were spent at the Huntington Labs and in the Department of Surgery at the MGH in Boston. He continued his surgical education with Martin Allgöwer. Felix Harder went on to become chairman of the Department of Surgery at the University of Basel, and is now retired. He acted as Secretary General of the International Society of Surgery from 2001-2009.

Society Zone in an interview with...

Felix Harder Secretary General of the ISS from 2001 – 2009.

Dr. Harder, could you tell us a little bit about the history and vision of ISS?

The Société Internationale de Chirurgie, as it was originally called, is the oldest international surgical body. It was founded in Brussels in 1902. In fact at that time only a few national surgical societies already existed, for example in Great Britain since 1843. Between 1870 and 1880 Germany, Russia, and the USA (the ACS followed in 1913) were founding their national surgical societies. However what was missing at the turn of the century was an organization that would facilitate an international exchange of views and news surgery.

In 1905 Theodore Kocher from Bern, Switzerland, who later became Nobel Laureate, delivered the inaugural speech at the first convention of the SIC in Brussels. The aim of this society was “to promote progress of sciences, to elucidate certain questions in surgery through international exchange of knowledge, experience and innovation”. The 214 participants at the Brussels congress in 1905 belonged to the international surgical elite and the society clearly defined itself as a top academic association gathering initially every 3 years . In 1914 the meeting was held in the US for the first time. US participants were, among others, Rosewell Park, Alton Ochsner, Harvey Cushing, and the Mayo brothers.

At the time, surgery was one entity covering all aspects of operative medicine. Several decades later and as a result of ongoing specialization, evolving specialist societies were progressively joining SIC/ISS. The first such integrated society was the International Association of Endocrine Surgeons which joined in 1979. This was also the year that the headquarters of the society was moved - at the initiative of Martin Allgöwer - from Brussels, Belgium to Basel, Switzerland.

Over a period of 100 years the surgical world has undergone radical changes. What are the objectives of the society today?

The statement of the founders mentioned above is still valid. Its application however has changed a lot as the demands of surgical communities have become so diverse in different areas of the world and frequently even in urban or rural parts of the same country. Surgery is no longer one entity but is split up into highly specialized, sometimes rather complex structures quite often more linked to non-surgical specialties than to other surgical fields.

Yet most surgical activities have much in common in clinical surgery, research, education, utilization of infrastructure and organization. One is misled in thinking that our ISS/SIC simply persists in defending general surgery. What is general surgery anyway? What in Chicago? What in Vilnius, in Amman? While our society is proud to count numerous international surgical leaders among its members, it has clearly opened up and welcomes representatives with various degrees of experience, of competence, of different background and professional orientation.

The opportunity to benefit from the availability of a great variety of expert knowledge at a high level, and to interact with colleagues with different professional interests and cultural backgrounds at the International Surgical Week every 2 years is always greatly appreciated.

One difficulty is very hard to tackle when trying to reach surgeons around the world: Surgeons from developed countries, especially the young surgeons engaged in their professional career will prefer and even be pressed to get ahead in their narrow field of specialization, fitting the demands in their country. They will primarily attend specialist meetings. On the other hand, surgeons from emerging countries where much broader surgery and not infrequently at a restricted level of complexity is being practiced may not even be in a position to get to the ISS/SIC meeting.

Has the ISS/SIC been able to develop ways to reach these surgeons outside of first world countries where the demand is particularly great for what the society is so well placed to offer?

The key of course is funding. It is limited. Basically there are 3 ways: go there, facilitate access to the International Surgical Week for representatives and make print or electronic media available.

1) Go there: The society has put up postgraduate courses in various parts of the world. Admittedly the number of surgeons reached is relatively small, but important human and professional relations have been created that way. We have also repeatedly sent a team of experts in a field of interest to some national congresses at the request of the host country.

2) Facilitate access: The Foundation of our society, often supplemented by other financial contributions, offers travelling fellowships to selected young surgeons. They were 26 from around the world at our last meeting in Adelaide. Altogether this is not going to change the face of international surgery but it clearly contributes to progressively building up an international network involving young surgeons who otherwise would not have access to the most valuable substance this society has to offer.

…and you have mentioned print and electronic media?

Of course. Today the World Journal of Surgery is the backbone, the lifeblood of our society. Without the Journal (and the revenue it generates to the society) ISS/SIC would not survive. From my point of view ISS/SIC – Springer is a happy marriage. All our members get 12 printed issues a year. In addition they have electronic access to the Journal and to back issues. Furthermore, members have free access to 11 Springer journals in surgery. In some countries it is barely possible to deliver the printed journal, however the internet is available. And the hits are increasing rapidly thus confirming the great appreciation the journal enjoys.

I may add here that the World Journal of Surgery first appeared in 1977 and that it has been edited by 5 distinguished chief editors, the fifth now being John Hunter from Portland, Oregon, efficiently supported by associated editors and a recently expanded editorial board and most notably by his wife Laura!

In the early years the society just issued congress volumes, then from 1936 to 1956 the Journal de Chirurgie, and the Bulletin in six languages (!) for another 21 years. News about the Society and its integrated societies circulates to our members via our Newsletter.

How is this going to develop further? Electronic scientific reading will certainly increase rapidly. It seems that the medical community is going electronic more rapidly than other groups. Management of data, of information, storage and retrieval as well as publishing is greatly facilitated by electronic reading. Refinements and adaptations of e-books will further promote the change. With Springer our society will adapt to the demand of our readers and institutions. Yet, comfortable reading next to a cozy fireplace will not totally disappear!

Society Zone thanks Felix Harder for this interview.

Historical data were collected from The History of ISS/SIC by Doris Liebermann.

About the Journal

World Journal of Surgery provides an in-depth, international forum for the most current, most authoritative information on major clinical problems in the fields of clinical and experimental surgery, surgical education, and socioeconomic aspects of surgical care. In addition to original scientific reports, the journal features "World Progress in Surgery", a special section presenting contributions from recognized authorities on a single topic of current importance.